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Absorbed dose and deterministic effects to patients from interventional neuroradiology.
Br J Radiol. 2000 Jul; 73(871):745-51.BJ

Abstract

Following the presentation of radiation-induced skin effects by three patients who had undergone glue embolisation of intracranial arteriovenous malformation (AVM), measurements were made of absorbed dose to the skin of patients undergoing other interventional neuroradiological procedures that involve long fluoroscopy times. The maximum absorbed dose to the skin measured by thermoluminescent dosemeters during these procedures was 4 Gy. From these measurements and from records of fluoroscopy time and the number of digital runs acquired, estimates of the maximum absorbed skin dose were made for the AVM patients. The best estimate of maximum absorbed dose to the skin received by any of the AVM patients during a procedure was 5 Gy, which is consistent with the skin effects presented by the AVM patients, that is temporary epilation and main erythema. Maximum absorbed dose to the skull was estimated to be 45 Gy and to the outer table of the skull 55 Gy. Although it is unlikely that the AVM patients will suffer serious effects from these skin doses, there remains some uncertainty over the risk of long-term effects to the skull. Examination of the fluoroscopy unit showed that the image intensifier was not performing optimally in terms of entrance dose rate and resolution. Replacement of the unit with modern X-ray equipment designed for interventional radiology was prioritized. Operators should be aware of the potential risks to patients from complex interventional neuroradiology procedures and should optimize their procedures to minimize such risks. Patients undergoing prolonged and complex procedures should be counselled regarding the symptoms and risks of large doses of radiation.

Authors+Show Affiliations

Northern Ireland Regional Medical Physics Agency, Forster Green Hospital, Belfast, UK.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11089467

Citation

Mooney, R B., et al. "Absorbed Dose and Deterministic Effects to Patients From Interventional Neuroradiology." The British Journal of Radiology, vol. 73, no. 871, 2000, pp. 745-51.
Mooney RB, McKinstry CS, Kamel HA. Absorbed dose and deterministic effects to patients from interventional neuroradiology. Br J Radiol. 2000;73(871):745-51.
Mooney, R. B., McKinstry, C. S., & Kamel, H. A. (2000). Absorbed dose and deterministic effects to patients from interventional neuroradiology. The British Journal of Radiology, 73(871), 745-51.
Mooney RB, McKinstry CS, Kamel HA. Absorbed Dose and Deterministic Effects to Patients From Interventional Neuroradiology. Br J Radiol. 2000;73(871):745-51. PubMed PMID: 11089467.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Absorbed dose and deterministic effects to patients from interventional neuroradiology. AU - Mooney,R B, AU - McKinstry,C S, AU - Kamel,H A, PY - 2000/11/23/pubmed PY - 2001/2/28/medline PY - 2000/11/23/entrez SP - 745 EP - 51 JF - The British journal of radiology JO - Br J Radiol VL - 73 IS - 871 N2 - Following the presentation of radiation-induced skin effects by three patients who had undergone glue embolisation of intracranial arteriovenous malformation (AVM), measurements were made of absorbed dose to the skin of patients undergoing other interventional neuroradiological procedures that involve long fluoroscopy times. The maximum absorbed dose to the skin measured by thermoluminescent dosemeters during these procedures was 4 Gy. From these measurements and from records of fluoroscopy time and the number of digital runs acquired, estimates of the maximum absorbed skin dose were made for the AVM patients. The best estimate of maximum absorbed dose to the skin received by any of the AVM patients during a procedure was 5 Gy, which is consistent with the skin effects presented by the AVM patients, that is temporary epilation and main erythema. Maximum absorbed dose to the skull was estimated to be 45 Gy and to the outer table of the skull 55 Gy. Although it is unlikely that the AVM patients will suffer serious effects from these skin doses, there remains some uncertainty over the risk of long-term effects to the skull. Examination of the fluoroscopy unit showed that the image intensifier was not performing optimally in terms of entrance dose rate and resolution. Replacement of the unit with modern X-ray equipment designed for interventional radiology was prioritized. Operators should be aware of the potential risks to patients from complex interventional neuroradiology procedures and should optimize their procedures to minimize such risks. Patients undergoing prolonged and complex procedures should be counselled regarding the symptoms and risks of large doses of radiation. SN - 0007-1285 UR - https://www.unboundmedicine.com/medline/citation/11089467/Absorbed_dose_and_deterministic_effects_to_patients_from_interventional_neuroradiology_ L2 - http://www.birpublications.org/doi/full/10.1259/bjr.73.871.11089467?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -